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Proposal seeks accreditation for public health school in 2015

The public health program is making significant headway toward becoming an officially accredited school.
The proposal has thus far been unanimously approved by the public health faculty, the Biomedical Faculty Council and the Academic Priorities Committee, wrote Terrie Wetle, associate dean of medicine for public health and public policy, in an email to The Herald. The proposal will be addressed by the Faculty Executive Committee in the coming week and will then be up for a faculty-wide vote at the November faculty meeting, Wetle wrote.
"I can't speculate on what's going to happen when the proposal comes before the Faculty Executive Committee," said Edward Wing, dean of medicine and biological sciences. But the committees that have passed the proposal so far have been "enthusiastic," he added.
If approved by the FEC and the faculty, the proposal will then need approval from Provost Mark Schlissel P'15 and President Christina Paxson. Schlissel will "certainly" endorse the proposal if it comes before him, he told The Herald.
If approved by Paxson, the proposal will then go before the Corporation in February, and if it receives the Corporation's approval, the University can apply for it to be officially accredited with the Council on Education for Public Health, a national public health accrediting agency. Though the official accreditation process could take up to two years, once the program has applied to the CEPH, it can be referred to as a school, Wing said.
 The school will comprise four departments: Behavioral and Social Sciences, Biostatistics, Epidemiology and Health Services, Policy and Practice, as well as 11 public health centers and institutes, according to the proposal.
"We have heard no dissent to date," Wetle wrote. "The support indicated by the unanimous votes ... is heartening."

A long time coming
"It's not as if we walked into the room and said, 'Let's make a school of public health,' and everyone raised their hand and said 'yes,'" Schlissel said.
Public health has existed as a program since 1995.
In 2000, Wetle was recruited to the University "with the idea being she would help expand this program in public health and get it to the stage when it would be appropriate to get it to a school," Schlissel said. "That's taken quite a number of years."
The Corporation voted to eliminate the Department of Community Health in 2011 and restructured the public health program into four departments, initiating the restructuring process that needed to take place for school formation.  
"All along the way, the Corporation has been keeping an eye on this and has on several occasions endorsed the idea that we should be heading towards this school for public health," Schlissel said.
Public health's transformation has included a four-stage strategic planning process, according to the proposal. Phase 1, which lasted from 2000 to 2002, involved the drafting of a "vision document." The next five years constituted Phase 2, which marked an "increased University investment in public health," the proposal states. From 2007 to 2012, Phase 3 involved identifying "specific opportunities in public health to be fostered," including organizational structuring and targeted faculty recruitment.
Pending the school's approval, Phase 4 will be launched from 2013-18, involving an "external review" and a "self-study" as part of the accreditation process.
The extensive strategic planning process has been accompanied by a growth in public health faculty to 164, and a 52 percent increase in undergraduate enrollment in public health courses in the last four years, according to the proposal.
Despite the extended time frame of the school's formation, the process is proceeding "all as we planned," Wetle wrote.
"There hasn't been any delay," Wing said.

Restructuring work
Formal accreditation requirements have required the public health program to undergo several major structural changes to become a school, Schlissel said.  
"The main difference is that we will no longer be within BioMed but rather will receive administrative and other services from the University," Wetle wrote.
As a program, public health has reported to the dean of the Division of Biology and Medicine, but as a school it will function as a "separate academic and administrative unit within Brown," according to the proposal.
Last spring a "major evolution" occurred in the reporting line of the school - incorporating the provost as the main administrative contact for the school, Wetle wrote.
"We wanted to be sure that we got this organizational question correct so the new school for public health, if approved, would be successful, and to ensure that remaining Division of Biological Medicine would not be hurt," Schlissel said.
The school will be funded through graduate student tuition, sponsored projects, gifts and endowments and the public health annual fund, according to the proposal.

Potential downsides
Though the school has been approved with unanimous support so far, the transformation is not without drawbacks.
One concern is that public health faculty will be siphoned off from the rest of the University and collaboration will be stifled.  
"We want to make sure we're not creating silos - we're not creating barriers to people interacting," Schlissel said.
In addition, one "definite downside" is that the school could create an "artificial dip in the rankings" of the Alpert Medical School, Schlissel said.
The medical school currently gets credit for all grant funding and research completed by public health faculty, who are all part of the Division of Biology and Medicine, Schlissel said.
"Even though we are making Brown as a whole stronger, there's a chance the medical school rankings will reflect Brown going down some notches because we're no longer counting public health research under the category of the medical school," Schlissel said.
Schlissel said he hopes any negative effect on the medical school "will be mitigated by the fact the medical school keeps getting stronger."
"We hope the medical school's continual slope of improvement will be
a balance for losing credit for the research dollars generated by the public health faculty," Schlissel said.

Benefits of accreditation
The creation of the school for public health accompanies a growing trend in the widespread influence of public health as a field of study, Wing said. An increased focus on prevention and end-of-life care is causing a "closer relationship" between public health and biomedicine, he added.
There are now 49 public health schools in the United States with official accreditation from the CEPH. While the first eight schools were accredited in 1946, since 2000 a total of 16 schools have gained official recognition, according to the proposal.
"If Brown wants to be in the playing field, this is something we just have to do," said Stefan Gravenstein, professor of medicine and health services, policy and practice. Forming the school is really about "formalizing the platform" and "giving voice to public health."
The creation of the school would be a "big plus" for the University, Wing said. The school will "strengthen the medical school as a whole" and "foster a closer relationship with Alpert," he said.
Wing also said school status would lend name recognition to the University's public health department and would increase competitiveness with other institutions.
Official accreditation would allow the school to "recruit even better faculty and even better students," Schlissel noted.
The public health school would become eligible for grants it cannot currently apply to as a program. For example, the Center for Disease Control and Prevention only considers giving grants to officially accredited schools of public health, Schlissel said.
The creation of the public health school marks a "critical step in the evolution of Brown as a university and as a health science educator," Gravenstein said. 
"It's good to have an umbrella to put (public health) under," he added. "When you're looking for someone to collaborate with, it's much easier if they are under the umbrella too instead of out on their own."

Steps taken so far:

Fall 2000
Terrie Fox Wetle is recruited to the University faculty and becomes associate dean of medicine for public health and public policy.

2000-02
Phase 1 of the Public Health Program's strategic planning mission to become an officially accredited school is launched. A vision document is produced, articulating the program's goals.

2002-06
The strategic planning process morphs into Phase 2. Seventeen new tenure track faculty positions are approved. In 2005, the Department of Community Health is organized into four sections: behavioral and social sciences, biostatistics, epidemiology and health services, policy and practice. In 2006, the public health program finds a home for its academic programs, and eight of the 11 centers and institutes at 121 South Main St.

2007-12
In Phase 3 of the process, the University looks to identify targeted faculty recruitment areas and define the school's proposed organizational structure. In 2011, University faculty and the Corporation approve the motion to make the four community health sections official departments.

Fall 2012
The official proposal to make the public health program a school is completed Sept. 9. The proposal is unanimously approved by the public health faculty, the Biomedical Faculty Council and the Academic Priorities Committee.


Looking ahead:

Fall 2012
The proposal will go before the Faculty Executive Committee in the coming weeks. If approved, it will come to a full faculty vote in November. The proposal will then need approval by President Christina Paxson.

February 2013
If approved by Paxson, the proposal will go to the Corporation for approval. The program of public health will then apply for official accreditation from the Council on Education in Public Health in 2013.

2015
Official accreditation from the CEPH would be granted at this time.


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